Case report: Mononeuritis multiplex in the course of dengue fever

Abstract

Background Dengue fever usually presents as a self-limiting acute febrile illness with worsening thrombocytopenia, with a small minority of patients developing hemorrhagic or life-threatening complications. Organ specific manifestations like myocarditis, acalculous cholecystitis, encephalitis has been described but are uncommon presentations. Even more rarely, such manifestations are the presenting complaint of Dengue fever. In this case report, we highlight a case of Dengue fever where unrelated neuropathies were the presenting complaint. Case presentation An elderly man presents with 1 day of diplopia and left foot drop, associated with 2 days history of fever. A decreasing white cell count (WBC) and platelet on the 2nd day of admission prompted Dengue virus to be tested and a positive NS-1 antigen was detected, confirming the diagnosis of Dengue fever. He was treated with supportive treatment with a short duration of intravenous fluids recovered uneventfully and was discharged 6 days after admission with almost full resolution of diplopia and partial resolution of left foot drop. Left foot drop recovered completely 2 weeks later. Conclusion Neurological manifestations can be the presenting symptoms in Dengue fever, a diagnosis which should be borne in mind when such symptoms present in patients from endemic areas or in returning travellers from these areas.

Unilateral lateral rectus palsy following dengue: A Case Report

“…The three main pathogenic mechanisms for the neurological complications of dengue infection were identified: (1) direct invasion of the CNS by the virus, leading to neurotropic effects such as meningitis, encephalitis, and myositis; (2) metabolic abnormalities causing CNS complications like encephalopathy, stroke, and hypokalemic paralysis; and (3) autoimmune complications, including encephalomyelitis, Guillain–Barré syndrome (GBS), cranial nerve palsy, and optic neuritis. All four serotypes of dengue virus (DenV-1 to DenV-4) have been associated with neurological manifestations in dengue fever 2 .…”

“…Approximately 390 million dengue infections occur annually across 128 countries, with 75% of this burden concentrated in Southeast Asia and the Western Pacific region. Notably, the Southeast Asia region reports a 1% fatality rate 2 .…”

A Neurological Manifestations of Dengue Infection: A Prospective Clinical Exploratory Study

“…In another recent case series of 7 patients of dengue fever with neurological manifestations, a case of mononeuritis m u l t i p l e x w a s o b s e r v e d w i t h s i m i l a r s p o r a d i c [19,20,21] observations.…”

Exploring the Intricacies of Encephalitis in Mosquito-Borne Diseases through Vector-Host-Pathogen Interactions: A Critical Review

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